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Sunday, April 7, 2013

Ischiogluteal Bursitis- A Real Pain In The Butt

I have been plagued by a very "awkward" injury. By awkward, I mean a pain in my butt.  I thought at first it was just a hamstring/ glute strain or pull from my Insanity workouts, but as the days past, it became more painful right at the bottom of my butt towards that lower bone. ( yes you have a bone in your butt cheek, It took an illustration for some to believe me).

For those that know me, well, you know that I continue to do things even when it hurts. So I ran the Dallas Rock and Roll Half with what I thought was a strained hamstring.  I had a great race and felt strong even through the middle miles which are usually tough for me. I did not have much pain while running.

It was a few days afterwards that it really started to hurt. And I mean a MAJOR PAIN IN THE BUTT!!
I debated whether or not to see the Doctor, but I hate them because they always tell me to "rest" and "don't run or workout"...blah blah blah  LOL  
So with some research I diagnosed myself ( It's not that hard to be a Doctor right? Everything is in Google LOL LOL)

I have most of the symptoms of: Ischiogluteal Bursitis, also know as Ischial Bursitis 
I like to refer to it as my BUTT BURSA.  

Treatment required rest, ice and anti inflammatories.  I rested for a few days. (Yes it was hard for me, but I sucked it up.) When my butt bursa was feeling better, I started back with very modified workouts. No jumping, no squats, and very minimal running. I have also done some physical therapy stretching and strengthening of the hamstrings and glutes.  Seems to be better! Slowly adjusting my workouts and should be OK to run my full marathon in 2 weeks.

Thank you for all who have said a prayer for my Butt Bursa!  

What is ischiogluteal bursitis?

Ischiogluteal bursitis is a condition that causes pain in the buttock and is characterized by tissue damage and inflammation to the ischiogluteal bursa. A bursa is a small sac filled with lubricating fluid and is designed to reduce friction between adjacent soft tissue layers. The ischiogluteal bursa is located at the base of the pelvis, at the level of the bony prominence known as the ischial tuberosity .
The hamstring muscles originate from the pelvis (ischial tuberosity) and insert into the top of the lower leg bones. The hamstring muscles attach to the pelvis via the hamstring tendon . The ischiogluteal bursa lies between the hamstring tendon and the pelvic bone (ischial tuberosity).
The hamstring muscles are responsible for bending the knee and straightening the hip during activity and are particularly active during running, jumping and kicking. During contraction of the hamstrings, tension is placed through the hamstring tendon which in turn places friction on the ischiogluteal bursa. Pressure may also be placed on the ischiogluteal bursa during sitting. When these forces are excessive due to too much repetition or high force, irritation and inflammation of the ischiogluteal bursa may occur. This condition is known as an ischiogluteal bursitis.

Causes of ischiogluteal bursitis

Ischiogluteal bursitis most commonly occurs due to repetitive or prolonged activities placing strain on the ischiogluteal bursa. This typically occurs due to prolonged sitting (particularly on hard surfaces) or due to repetitive running, jumping or kicking activities (placing strain on the ischiogluteal bursa via the hamstring tendon). Occasionally, patients may develop this condition suddenly following a direct blow to the ischiogluteal bursa. This may occur due to a fall onto a hard surface.

Signs and symptoms of ischiogluteal bursitis

Patients with ischiogluteal bursitis typically experience pain in the lower buttock. In less severe cases, patients may only experience an ache or stiffness in the buttock that increases with rest following activities placing strain on the ischiogluteal bursa. These activities typically include sitting excessively (especially on hard surfaces), walking, running, jumping, kicking or climbing stairs. The pain associated with ischiogluteal bursitis may also warm up with activity in the initial stages of the condition.
As the condition progresses, patients may experience sharper or more severe symptoms that increase during sport or activity, affecting performance. Patients frequently experience pain on firmly touching the ischiogluteal bursa and hamstring tendon . Occasionally, a feeling of lower limb weakness may also be present particularly when attempting to accelerate whilst running.

Diagnosis of ischiogluteal bursitis

A thorough subjective and objective examination from a physiotherapist may be sufficient to diagnose ischiogluteal bursitis. Further investigations such as an Ultrasound, X-ray, CT or MRI scan are often required to assist with diagnosis and assess the severity of the condition

Prognosis of ischiogluteal bursitis

Most patients with this condition heal well with appropriate physiotherapy and return to normal function in a number of weeks. Occasionally, rehabilitation can take significantly longer and may take many months in those who have had their condition for a long period of time. Early physiotherapy treatment is vital to hasten recovery in all patients with ischiogluteal bursitis.

Contributing factors to the development of ischiogluteal bursitis

There are several factors which can predispose patients to developing this condition. These need to be assessed and corrected with direction from a physiotherapist. Some of these factors include:
  • joint stiffness (particularly the hip)
  • muscle tightness (particularly the hamstrings and gluteals)
  • inappropriate or excessive training
  • muscle weakness (especially the hamstrings and gluteals)
  • inadequate warm up
  • poor biomechanics (e.g. excessive stride length)
  • poor core stability
  • neural tightness
  • leg length discrepancy
  • inadequate rehabilitation following a previous buttock injury

Has anyone else ever experienced this before? Or am I the only one with awkward injuries?


  1. Crazy!! I have been having a pain in the butt too!! I was thinking what I have been experiencing is piriformis syndrome....(SP?)

    I was thinking I started to hurt there because I was suffering from shin splint which may have altered my stride.....

  2. Wow Pam! I hope you feel better soon! I have been lucky to never experience this, but I love how well you explained it so I will know in the future. :)

  3. I hope your butt is totally better in time for your marathon! Otherwise, get some lavabuns to sit on! LOL :)